What sabotage governing looks like

I was talking to a friend over the weekend about current events, and when the subject turned to health care, I mentioned Republican efforts to “sabotage” the Affordable Care Act. He asked a fair question: “In real-world terms, what does that mean, exactly?”

It occurred to me others might be wondering the same thing. While Greg Sargent and I talk about “sabotage governing” quite a bit, it’s easy to lose sight sometimes of just how sweeping the GOP efforts to impair the federal health care law really are. We’ve never seen anything like this – it is literally without precedent – and for millions of Americans, very little matters more.

So let’s get specific. When we talk about efforts to “sabotage” Obamacare, what are we referring to? Several – by my count, seven – specific efforts.

First, congressional Republicans are actively trying to undermine the federal health care system by refusing to help their own constituents navigate the system.

People regularly call their representatives for help with Medicare, Social Security and other government programs. Yet, Republicans believe healthcare reform spells doom for the federal budget, private businesses and the U.S. healthcare system. They’re also enormously frustrated that the law has persevered through two elections and a Supreme Court challenge and believe a botched implementation could help build momentum for the repeal movement.

Some Republicans indicated to The Hill they will not assist constituents in navigating the law and obtaining benefits. Others said they would tell people to call the Department of Health and Human Services (HHS).

“We know how to forward a phone call,” said Rep. Jason Chaffetz (R-Utah). He added, “[A]ll we can do is pass them back to the Obama administration. The ball’s in their court. They’re responsible for it.”

Constituent services are the most basic of tasks for congressional offices, but we now have some – not all, but some – congressional Republicans who simply don’t want to help constituents who need a hand with information about federal health care benefits.

Second, there’s systemic lying to the public.

In recent weeks, officials in states like New York and California have boasted about lower premiums for residents thanks to the Affordable Care Act. But on Friday, Indiana, where Republican officials dominate, announced the law would force a premium increase of 72%. How it that possible? As Sarah Kliff, Jonathan Cohn, and others explained over the weekend, GOP policymakers in the state arrived at the figure by cooking the books and jumping to conclusions based on incomplete information.

Indiana Republicans wanted to push a political narrative, and generate some headlines, but they had to play fast and loose with the facts, on purpose, in the hopes of fooling the public.

Third, there are the dozens upon dozens of repeal votes congressional Republicans keep holding. The latest was last week, and yesterday, House Speaker John Boehner (R-Ohio) vowed to hold even more, saying he still hopes to “derail this thing,” and adding, “We’re going to do everything we can to make sure it never happens.” (Boehner said the exact opposite last November.)

These repeal votes tell the public that the future of the law is still in doubt – a significant chunk of the country actually believes the Affordable Care Act has already been repealed – and discourages participation needed to make the law work.

Fourth, congressional Republicans have repeatedly denied the Obama administration funds needed for implementation. Fifth, GOP leaders have shamelessly discouraged private-sector partnerships with Washington on public-awareness campaigns, in the hopes that public ignorance might help undermine the efficacy of the system. Sixth, many Republicans at the state level are refusing to allow Medicaid expansion, no matter how much damage it does to their state. And seventh, these same GOP officials in the states are refusing to create exchanges, making it that much more difficult for federal officials to meet deadlines and fully implement the law on time.

When I talk about efforts to “sabotage” Obamacare, this is what I’m talking about.

Again, don’t forget that this has simply never happened before. There is no precedent in American history for Congress approving a massive new public benefit, a president signing it into law, the Supreme Court endorsing the benefit’s legality, and then having an entire political party actively and shamelessly working to sabotage the law.

We can talk about why Republicans are doing this – Paul Krugman has some compelling thoughts on the matter – but the fact that these sabotage efforts are underway is undeniable.

As Jonathan Bernstein recently explained, “It’s possible that the ACA will collapse. But if it does, it’s unlikely it will be the result of inherent problems with the legislation. If Obamacare fails, it’s going to be because the Republican Party’s all-out war on it – a war that doesn’t seem to have any concern at all for health-care consumers or the economy – succeeds. Whether that’s a good thing for health care? Well, that doesn’t seem to be part of the equation.”